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Home My WebLink AboutBLD2005-00088 ItUILDING PERMIT APPLICAN MLA05-00092 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00088 Received Date: 2/16/2005 SITE ADDRESS: 741 RHODODENDRON RD QUILCENE, 98376 OWNER: DAVID RIGGS PHONE: VANESSA RIGGS PO BOX 3 PORT GAMBLE WA 983640003 SUBDIVISION: Block: Lot: PARCEL NUMBER: 601031005 Section: 3 Township: 26 N Range: 01 W CONTRACTOR: RIGGS CONSTRUCTION PHONE: (360)779-6222 PO BOX 3 PORT GAMBLE WA 98364-0003 Contractor's License RIGGSC*028RW Expires 5/2/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI ADD ATTACHED CARPORT TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 9,617.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: 408 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Floodplain % F&W Landslide Routing Dat //6/03 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Dace: Receipt: Approved/Date Permit $181.25 BAC 02/16/05 71462 APPROVED Plan Check $117.81 BAC 02/16/05 71462 �/ State Building Code $4.50 BAC 02/16/05 71462 MAR 2 3 2005 Total: $303.56 Jefferson County Planning Building Department e 0 BUILDING PERMIT Jefferson County Departnient of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00088 Received Date 02/16/2005 SITE ADDRESS: 741 RHODODENDRON RD Issue Date 03/23/2005 QUILCENE, 98376 APPLICANT: DAVID RIGGS PHONE: VANESSA RIGGS PO BOX 3 PORT GAMBLE WA 983640003 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 601031005 Section: .3 Township: 26 N Range: 01 W CONTRACTOR: RIGGS CONSTRUCTION PHONE: (360)779-6222 PO BOX 3 PORT GAMBLE WA 98364-0003 Contractor's License: RIGGSC*028RW Expires: 5/2/2006 PROJECT DESCRIPTION: ADD ATTACHED CARPORT CALL IN FOR THE REQUIRED INSICTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: ex;//L/e_vo'i` UFFER: /XA Footing: (.9e`04.A6C Foundati,on: Stormwater FINAL Approval: Underground Plumbing: Underground Insulation: Shear Wall : Sheathing: Framing: Plumbing: . Propane Tank/ Lines: Insulation: Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY - SEE REVERSE W • SPECIAL CONDITIONS FOR C E # BLD05-00088 1.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 2.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 3.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 4.) All construction activities shall not encroach upon the buffer. This includes the storage or preparation of materials. 5.) The applicant shall permanently separate the boundary cf the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 6.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 7.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 8.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 9.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 10.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. ��g �sON CO6 JEFFERSON�UNTY •• z7 f DEPARTMENT OF COMMUNITY DEVELOPMENT `' " ' 621 Sheridan Street • Port Townsend •Washin on 98368 360/379-4450 • 360/379-4451 Fax 6 ?x -, �.qs, p� www.co.jefferson.wa.us/commdevelopment $IN Master Permit Application MLA. Q �' Project Description(in ude separate sheets has necessary): !/1/C."t/ cvAcid (2 r-fib— Tax Parcel V Property cb Number: 0 / Q3/ CD°C- Size: ici.0 (acres/square feet) Site Address and/or Directions to perry: 77�� nd� �r �� D W. g3 76 Property Owner(s)of Record: ORv t d !' (/4"L.'s cct Z► g5 Telephone: MO 77g 6ZZ z_ Fax:,,6O '7 79//at— email: Mailing Address:v . 3 74 6a.rru 6 , r,JA- 9'$3CY Applicant/Agent(if different from owner): 5a_ & Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) Building ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]** ❑ Single Family f-- ❑ Discretionary"D"or Unnamed Use Classification _Garag: .«.>e ietached ► d"-- ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment Li Modular ❑ Short Plat** Commercial* ❑ Binding Site Plan** ❑Change of Use ❑ Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application fonn,the owner/agent attests that the information provided herein,and in any attachments,is true-and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomey's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access a ght o ntry to Jefferson County and its employees,representatives or agents for the sole purpose of application review an later ins( ctions.A ss and right of entry to this property shall be requested and shall occur only during regular business ::re : _?— Date: i —erg The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not I e the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)eve if ou are in plian with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transf ble sibility for d en Oo and complying with the ESA. The Applicant has read this claimer and signs and dates it below. Signature: Date: _—(3-cr.( G:\PemritCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc 04 • OWNER BUILDER STATEMENT • The signer of this statement d hereb at they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be ass the res sibility of e I Contractor for the proposed project. Signature: \l` ro Date: /3— GENERAL(CCOONTRRA///CTOR OR MANUFACpTURED HOME INSTALLER: P2HONE: `� L FAX: \ 7 , 5 __ 4,--,7, 60 MAILING ADDRESS 4,,?, 3 /a mb� EMAIL: CONTRACTOR'S LICENSE y "1O ace( WAINS NUMBER: /—/C Sc 4. oz.,, 4) NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New y Wood Existing: ❑ Sewer Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: 9 Individual System ❑ Repair ❑ Masonry SEP Permit# 'f/>/ ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: El Public , M Total: Name of System: If this is a Commercial Proiect you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: ❑ Underground Tank ❑ Above ground Tank Size of Propane Tank: i I Heat Stove ❑ Cook Stove ❑ Woodstove [7 Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove [7 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage For Office Use Only Current Proposed Amount Main Floor Consistency Review: 4.%2""Floor Base fee: 5. I 8l . 3fd Floor Additional Section: ,___. _q Mezzanine: Plan Check fee: l 11 2 { Heated Basement State Surcharge fee: 5d Unheated Basement Pot Water Review fee: Other Unheated 911/Rd Approach fee: Garage/Carport tie q ttY 5� TOTAL $ r Decks r Receipt Number. . 1 7 1 1 (0„... Other Cash/Check Number: r7 co, FEB 6 1n- ESTIMATED COST(REQUIRED) Date: • , '"" •Fair market value of all latxlr and materials foundation to finish I ja�j Initials. G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc ,3 .,.., ..".. t c\iIrk .) ,cP (...,.7 ) CY cIN t. VJ ZS. Ch CI _' i t° i: ' N. LIN 1/4.A lsi pa 4441,0415er-cr f" It:' th (\ 4....„ (t, V ." -q {e.- 12 \ , \ . 4_1-- , N r t -.... ..... ..... , I/ t oC ih ,tJ \\:, v ,. 1 -- -E a� li 11.... ,_., N ! 1 L 9�S 9 , 1-- APPROVED 3 ; f SITE PLAN MAR 2 2 2005 L. JEFFERSON COUNTY �- flt'PT.OF CO. ;;4, I DE}� OPMENT SIGN'ATIJRE: / ��rff